Bussmann W D, Kenedi P, von Mengden H J, Nast H P, Rachor M
Abteilung für Kardiologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt.
Z Kardiol. 1993 Jan;82(1):33-7.
To determine whether nitroglycerin is just as effective as nifedipine in lowering the blood pressure in excessive hypertension and hypertensive crisis, two groups of 20 patients received in random sequence either 1.2 mg of nitroglycerin sublingually or a 10 mg nifedipine capsule, which was chewed and swallowed. The blood pressure fell after 5 min in the nitroglycerin group from 211/122 mm Hg to 171/95 mm Hg and after nifedipine from 210/118 to 185/102 mm Hg. The greater effect of nitroglycerin results from faster absorption through the oral mucosa than through the small intestinal mucosa where nifedipine is primarily absorbed. After 15 to 20 min a satisfactory reduction in blood pressure was reached in both groups: 157/91 and 158/92 mm Hg, respectively. After 30 min the heart rate in the nitroglycerin group had decreased from 83 to 80/min, but in the nifedipine group it had increased from 84 to 90/min. The reduction in blood pressure persisted up to 6 h. No significant difference in side-effects was determined. Since a hypertensive crisis is usually accompanied by left-ventricular failure, pulmonary edema or angina pectoris and infarction, and nitroglycerin has been definitively shown to positively influence these conditions, preference should be given to nitroglycerin in the treatment of hypertensive crisis.
为确定硝酸甘油在降低重度高血压和高血压危象患者血压方面是否与硝苯地平同样有效，两组各20例患者随机序贯接受1.2 mg硝酸甘油舌下含服或10 mg硝苯地平胶囊（嚼碎后咽下）。硝酸甘油组血压在5分钟后从211/122 mmHg降至171/95 mmHg，硝苯地平组血压从210/118降至185/102 mmHg。硝酸甘油效果更佳是因为其通过口腔黏膜的吸收速度比硝苯地平主要吸收部位小肠黏膜更快。15至20分钟后两组血压均降至满意水平：分别为157/91和158/92 mmHg。30分钟后硝酸甘油组心率从83次/分钟降至80次/分钟，而硝苯地平组心率从84次/分钟增至90次/分钟。血压降低持续长达6小时。未发现副作用有显著差异。由于高血压危象通常伴有左心室衰竭、肺水肿或心绞痛及梗死，且已明确表明硝酸甘油对这些情况有积极影响，因此在高血压危象治疗中应优先选用硝酸甘油。
